Social Minimalism’s Pigeons Back Home to Roost in Health Care Debacle

Change, the legions who voted for Barack Obama for President in 2008 wanted.

Well, as legislators broke for their August recess it appeared changes in the way health care is delivered in this country certainly wasn’t to be one of them. At least if you listened to angry Republicans particularly in the Sunbelt states.

The hostile receptions members of Congress got at their initial town-hall meetings, from newspaper reporting and from the footage shown on national television, looked more like an orchestrated assault on everything resembling Change than it did the grassroots Democracy expressed at last years polling places. What happened?

Ah, the perils of Social Minimalism’s featherbedding! The pigeons of the 20th Century Sunbelt Era’s rush to riches, which it’s argued minimalized our humanity, i.e., exchanged our sacred indebtedness to care for each other for an unwritten moral code of feathering our nests, have finally come home to roost, it seems.

Preaching Change is one thing! Taking money out of my pockets to pay for it is something entirely different! the voices almost seemed to be saying in unison in those TV clips.

Folks, the transformation of our nation’s basic egalitarian, altruistic morality values by the Sunbelt Movement can’t be continually dismissed as non-perverse. Greed is self-destructive; somewhere Reconciliation to those left out, dumped off or cut out by the movement has to occur. Health care is a prime arena in which that singular act can occur.

The relocation or expansion of industries to southern and southwestern states opened up a flood gate of new
investment opportunities that benefited us all in some ways, yes. But those benefits not only transformed our physical surroundings to our betterment, the New South and New Southwest, but in the process they changed, morphed, the way we treated each other, too. Most noticeably, of course, in the transferring of mostly northern manufacturing jobs overseas and abandoning old communities to reassemble their lives in new, different and oftentimes awkward ways. And shoving old, caring-for-one-another values in the Sunbelt states aside to accommodate the explosion of Growth. Whatever it takes became the mantra.

This has become known now as Social Minimalism, a neo-epicurean philosophy to expound on our rush to excel versus our innate selfishness and laziness. In the Sunbelt, if you couldn’t cash in on the opportunities in this new transformation, go with the flow in a greedy rush toward what became an exercise in mass, largely unregulated capitalism, then you were left out of it; viewed as something slightly less than what was considered the standard flag-bearer for a normal human being. You were minimalized. And now, decades later, what has happened?

You see many family doctors or practitioners anymore? What about the number of private hospitals? Or county-owned hospitals that were the bulwarks of a stable society once? Before opportunities for profit arose! And, on the other hand, have you noticed the surge in corporate hospitals? And in insurance businesses, and their junk mail, and all the additional claims-related companies? Oh, yes, that’s additional jobs! We’re high on the hog! Or were.

And look, too, at the surge in legal counsels who honed in for an increased killing in malpractice lawsuits that a plethora of growth situations opened up in all industries and professions. And the army of cottage industry lobbyists that all those situations have created in Washington. You see it?

And what was the effect on all that when the economy collapsed in late 2008 and we started spinning rapidly toward a Depression? And with the well-heelers on Wall Street screaming the sky is falling, Obama stepping in with a slew of what high-on-the-Sunbelt-hog Republicans immediately labeled as socialist proposals to stop the economy’s bleeding? Huh?

There’s so much mad-dog anger now you can almost see the saliva foaming on some of the people’s mouths. Whooeee! We’re in a premier, national Showtime period, folks. Showtime! Sit back; bring out the beer and popcorn. Crank up Shall We Gather At The River!

Perry Aug. 3 of wanting to secede from Reality. The Guv already had stuck his foot in his mouth a couple of months earlier when at a tea party rally he suggested Texas exercise its right to secede from the union if Obama kept up his social legislation barrage.

Shapleigh, a sharp-tongued lawyer himself, countered in an opinion piece in the vaunted El Paso online Newspaper Tree that under Perry’s decade of leadership Texas, indeed, had distinguished itself in many ways.
* Texans breathe air with more carcinogens than citizens of any other state.
* Perry’s highway department is broke; within two years…the department will have no money to build new roads.
* On the streets of Texas, predatory lenders now charge Texas families interest rates of 1100% per year.

And on the issue of health care, he spared no punches. Ooohh! Pobresito, el Guv!
* By percentage and number, Texas has more uninsured than any state in America, with one out of four Texans lacking health insurance. In some Texas counties, up to 40% have no health insurance. Contrary to the claims of some, even if non-citizens who include legal residents as well as undocumented immigrants were removed from the statewide estimate, Texas would still have the highest uninsured rate in the country with 4.1 million uninsured citizens.
* One in six uninsured American children resides in Rick Perry’s Texas.
* Our state ranks in the bottom ten in the U.S. when it comes to the number of physicians, dentists and nurses per capita. Here in El Paso, with thousands of new troops on the way to Ft Bliss, we struggle to provide care with fewer doctors and nurses per capita than any large city in the country.
* Texas is second in the U.S. in teen pregnancies.
* All 13 of Texas’ state schools for the mentally retarded have been under a Department of Justice investigation for systemic abuse and neglect. Fight Clubs at the Corpus Christi State School, where staff pitted residents against one another, recently made headlines on CNN.”

This the reality of Rick Perry’s Texas today, Shapleigh wrote. When change is on the way, Perry talks of suing the U. S. government to stop it.
*Who benefits from Rick Perry’s reality? In Texas today, three of the most expensive hospitals in the U. S. rake in profits, with charges that are almost three times the national average.

And on and on. Folks, indeed, we’re in for a bloodletting before this thing is over. With so much finger-pointing going on, you could load up Texas Stadium in Irving with 3-year-olds, give them all the mud buckets they wanted, and they still wouldn’t stand a slinging chance up against what’s going on in the nation’s media circus.

The reality of the situation, however, remains. The debts of our hedonistic Social Minimalism lifestyles the past few decades have got to be paid–one way or another–before we can ever call ourselves a caring people again. If that’s what we really want. No amount of verbal warfare, regardless of the relevancy, is going to change that. So, if we take the voices of The People at the polls as having said yea, how do we do it? How do we make a reckoning with our spiritual selves? For our slighting others along the way in a rush to lift up our own vanities?

The proposals, equally, are myriads in numbers. Me–an old, beat-up newspaper warrior from the Sunbelt days who ended up recently as a retired justice of the peace in Presidio, a small, Far West Texas border community in the Big Bend–I still tend toward getting them in the print media, albeit there’s so much good stuff on the internet these days, too. Electronic print, call it. The Tree there in El Paso always has good stuff .

But just experience itself is enough to convince a person doctors increasingly are shackled by exorbitant malpractice insurance rates. It just makes sense to cap them. Presidio, for instance, is stuck so far into the mountainous Chihuahuan Desert up until early this year doctors on a steady basis were rare for the community, for decades. We had one here from Austin four years ago; hospital administrators 90 miles away touted him as our answer, finally.

Personally, I’ve got more than a touch of COPD, or chronic obstructive pulmonary disease, from 30 years of smoking cigars; got so sick with the flu one winter I thought I was going to die in one of his clinic’s waiting rooms. Loaded with patients, he was. My wife finally went somewhere in one of the other rooms and got him to come look at the old judge’s blue fingers. I was on my way out of here to the Great Beyond and going without a whimper.

Get an oxygen bottle! he hollered at someone. And they kept me on it until the ambulance arrived at the hospital. Ninety miles away.

But two months later this doctor, who’d volunteered to work in Presidio to help pay for some of his medical school costs, had to pack up an leave. Couldn’t afford the $100,000 annual malpractice insurance rate, he said.

I need more customers like you Dan! he blithely told me one day. As an employee of the state’s County of Presidio, I had county health insurance, of course. Most of these people here have Medicare. And the loudest critics of Obama’s plan say those rates will drop even lower to health professionals if Obama’s plan is approved. As one of my favorite quotes from the overseas Great Iron Lady, Margaret Thatcher, goes, The problem with socialism is that you eventually run out of other people’s money.

To convolute the emotions in this issue more, turn back to The Tree. On the same day Shapleigh accused El Guv of wanting to secede from Reality, another article, one of a series, that ran on the issue from a business development manager, pretty much summed up our real reality. Jim Collins, who describes himself much as how all of us old Democrats in the Lone Star once did, a fiscal conservative and social liberal, wrote in part 3 of his What Health Care Crisis? of his own fear and anger.

Why am I afraid? I’m afraid because I am going broke paying for private health insurance,” he said. ” I am afraid that with the current federal government proposal I will be paying even more and receiving even less. I’m afraid to even use the health insurance I have because every time I have, it has been followed by a large bill anyway. I’m afraid that after paying for health insurance my entire working career, in the end I will go bankrupt and leave nothing for my children as my saving are taken to pay for medical care as I lay dying.

Whooo! Take another large breath.

Why am I angry?, he then asks. I’m angry at the health insurance company that takes over $8,000 per year out of my pocket and seemingly provides little in return. I’m angry because I was foolish enough to study this topic. My study showed me just how much profit these health insurers are making, and how much of that profit is spent on lobbying politicians, bloated salaries for executives, fines paid for denying legitimate claims, and hundred of other things that do nothing to reduce my premiums or improve the care I receive.

I’m angry because despite the billions of tax dollars dedicated to health care for the poor and the elderly, we still hear about millions that do not receive adequate health care. I’m angry because everyday I read of the games played by health care providers to dump the uninsured onto the public system, and of the public system delaying and denying services simply to keep their system running. I’m angry with health care professionals gaming the system to increase their reimbursement rate (in the worse case), or to make the required treatment fit the restrictions of the health “plan” that will cover the cost. I’m angry with the government bureaucracy with its ever decreasing reimbursement rates and complicated accounting system that push providers to do so and add administrative cost to the whole system.

Why am I disappointed? I’m disappointed because it is obvious to me that our elected officials are listening more to the lobbyists for the doctors, insurers and lawyers than they are actually debating what is the right thing to do.

Capping lawsuit damages is just one part of the solution. There’s something else sequentially that needs to be done. Call it the Texas Two-Step. If you’re away far off somewhere such as down here in the desert you can see it. It’s plainly simple. If you’re going to cap malpractice damages, at some point you’ve got to put a cap on physician’s salaries, too. It’s that simple.

Why? Because if you’re going to take from the public trough, e.g., once you make a decision as a private physician or other health care professional to accept government programs such as Medicare and Medicaid, there has to be limits. And, on the other hand, if the public is going to shield you from excessive damages and inordinate amounts of law suits for the way you conduct your medical practice, there has to be public accountability, too.

As the old saying goes, if you’re going to sip of the public wine, you can’t bawl like a private year-old heifer when an innocent but stupid blunder results in someone’s tragedy. Life is not fair works both ways. We’re all learning that. Some of us painfully. Which is what wisdom is, some great poet I can’t remember once wrote. We all grow wise against our will I think were the words to the poem. But call the Texas Two-Step the New Reality brought on by our rush to riches in the Sunbelt Movement and the subsequent re-shaping of our international economy. Men and women just aren’t perfect. Again. And again. Indeed.

At Texas A&M in the Corps of Cadets once, in my first year there, one of the guys had this humorous but true saying about what the serpent really told Eve when coaxing Adam to take a bite out of that apple. Man, in all of his creative blissfulness, simply can’t be trusted, it seems. One bite, then take it away from him! You could turn him into a UT tea-sipper if you gave him more! the Aggie serpent said.

Which brings me finally to a Political Science professor I had once at another school. He’s still alive, I think; I’m not mentioning his name; nor the school. But he discussed the nation’s redistribution of wealth problem once in a very somber lecture. He actually advocated setting minimum and maximum incomes on all professions and waged jobs. The lecture went something like this:

Benevolence, benevolence, benevolence! he said, gesturing toward the ceiling each time with one hand I remember. We are a benevolent people! All the world knows it! So take away all the attention paid to people with insane amounts of wealth! Put it instead on the amount of good they’re willing and able to contribute to society!

Whoosh! Yes, students were aghast. He actually had a plan set down on paper whereby professionals, clericals, labor jobs, sales, even the clergy, would be ranked much like the military in accordance to how high they’d advanced in a certain trade or profession, and ranked and respected accordingly. Psychologists, you see, claim that if an ordinary person gets all the attention he or she consciously wants, they’d only be getting 65 percent of what the mind actually needs. Thus man in his infinite creative blissfulness subconsciously schemes these behavior patterns to pick up the rest. Making bundles and bundles of needless cash just for the glory of it is one of them.

But according to the old professors reasoning, substituting rank instead of money would bring in all the attention the human being craves, and it would by new definition be strictly positive attention. The way we have it now, attention is attention, be it good or bad, for it works to fulfill the mind’s craving all the same. And we wouldn’t have to lay awake at nights scheming how to get more; civilization would advance much quicker, and much more peacefully than then (and still now), being pulled jerkily along by the quest for profit system.

And no one yet I assumed his colleagues has been able to prove me wrong! he added for final accent. Can’t remember for sure but I think everyone was so shocked then no one could think straight enough to remind him of all those technological improvements the quest for profit has led mankind to. A minor point maybe.

But for years, I thought that guy was crazy. He may have had more than one bite out of the apple, I’m not sure. But I definitely don’t think he was an Aggie. It was the Vietnam era and university campuses were crawling with whackos. But now, looking at what needs to be done in the health care debacle, you wonder. Maybe he had something!? Who knows how this is going to play out finally?

But I do deeply believe and trust in God, and the outcome of this nation and its role in fostering that better place the religious prophets spoke so much about through the ages, the thought that lies on the precipice of most of our consciousnesses now. We’ll make it, one way or another, folks. Call it Destiny’s Yearning. It’s like I tell my old coffee buddy when he starts ranting and raving about all the insane things people do these days. There are no bad people in this world, I tell him. Only bad ideas.

Lynching the Texas governor for wanting to secede from the United States of America is one of them. I know this guy. He was cadet corps commander his senior year at Texas A&M. The Guv only had one bite.

Believe it or not.

Obama Health Care – How it Affects Middle Class Americans

Obama health care has received mixed emotions from people all over the nation. Some are in favor, others feel that the government has completely taken control of their rights. For the middle class Americans, many believe Obama care will adversely affect themselves and the upper class. While it does make significant changes to our current system, every class will be affected in one way or another.

It is believed by many individuals and institutions that low-income families will benefit greatly, and have health insurance for perhaps the first time ever. However, this benefit to the lower income class means that high-income families will pay considerably, most of it in the form of increased taxes. Obama care is a touchy subject with many Americans, who feel they will be forced to pay stiff penalties if they do not buy health insurance coverage.

Middle class Americans feel that they may suffer the most, and cannot see a way out as they attempt to pay for basic necessities such as childcare, food, housing, utilities, etc. In their minds, it they are already struggling to meet these obligations, how in the world can they afford health insurance? But if they don’t purchase it, according to Obama laws they will face penalties if they fail to get health insurance coverage.

Struggling with the rising cost of insurance has been a problem for years, and the debate has continued regarding how to get the United States health care system under control. Under Obama health care, families who earn in excess of $250,000 per year will face an increase in Medicare tax from 1.45% to 2.35% – same for individuals who earn $200,000 per year. Since there is now no option regarding whether an individuals decides to purchase health insurance coverage or not, they will face penalties.

Americans who already have health insurance may think “So what? What’s the big deal?” In fact, Obama health care may affect those who previously had health insurance coverage. While it seems that having more people paying in to the system would mean lower insurance premiums, that may not be the case. According to congressional estimates, by the year 2016 individual premiums may be 10 to 13% higher than they are currently.

Several factors that play in to the equation include the fact that in 2014, insurance companies will no longer be able to deny coverage or charge increased premiums due to existing conditions. Add to that the fact that shortly thereafter, insurers will no longer be able to set lifetime limits on coverage, nor will they be able to drop insured individuals who become ill. What does this mean? In a nutshell, Obama health care means that more sick people will be covered, and those costs are greater to insurance companies than those of healthy individuals. All of this may ultimately counteract the benefits of a larger health care pool.

At the current time, it is difficult to determine exactly how it will affect Americans in specific classes, or who will ultimately end up paying the most for mandatory health care coverage. One thing is for certain – while some believe that this is the best thing since buttered bread, others aren’t nearly so optimistic. In a few years, we will all be able to determine just how Obama health care has affected our lives personally.

Health Coaches Needed For Health Care Reform

Most of the Congressional debate for health care reform revolves around ways to extend reimbursement for sick care. However, paying for more of the same fragmented, costly care isn’t reform, it’s madness.

The $2.2 trillion health care system, the costliest in the world, requires a new top-to-bottom vision, and although the 600 doctors and health professionals gathered at the Institute of Medicine’s Summit on Integrative Medicine last month didn’t agree on everything, they reached a resounding consensus about the need for Americans to change their health habits. Yet how can that best be accomplished?

With a primary shift toward health promotion, disease prevention and wellness, a revamped health care system could put the brakes on the disastrous trajectory predicted for 2012, in which total health care costs would equal 20% of the Gross Domestic Product (GDP). Providers, employers, and even insurance companies finally concede that the US would fall behind the world’s nations in every imaginable sector if one out of every dollar of our productivity went toward health care costs.

For over 30 years, the National Wellness Institute has been reporting that 8 out of 10 Americans suffer from chronic ailments derived from unhealthy lifestyles: poor diet, inadequate physical activity and unmanaged stress. Yet the difficult task of behavior change has always fallen on individuals, without much support from the medical system or their doctors.

In addition, cultural support has been lacking for the most at-risk populations, often minorities with higher rates of diabetes and obesity. At present, there are more obese Americans than overweight ones-an almost unthinkable statistic.

Cultural support for healthy lifestyles starts with community activists demanding bike paths, public parks, safe streets, farmers’ markets, fresh food options and more from their local governments. Together with cooperation from industry, government, health care, and public health officials, pressure can be placed on developers to build environments that provide opportunities for physical activity. Teachers, parents and consumers can demand that Big Food stop advertising cheap, non-nutritious, calorie-dense, processed foods to kids and young adults. Schools can offer nutrition and PE classes again, and lunch programs can teach kids about healthy choices-and provide them!

Should Your MD Get Paid to Teach Wellness?

“Lose weight, stop smoking, start exercising, and cut down on your stress-and I’ll see you next year for your physical.” Everybody knows that the once-a-year admonition from your doctor rarely translates into new health habits.

A new tier of health coaches can supply the support and encouragement needed for Americans to begin their journey towards maximizing personal health. Health coaches should be part of every public clinic, medical office and hospital wellness center. They should be reimbursed by insurance companies, or be part of the first-access tier of Medicare, Medicaid, private insurance companies and corporate wellness programs. Even Dr. Mehmet Oz suggested that health coaches should be considered a central part of health care reform to CNN’s medical reporter Dr. Sanjay Gupta.

Instead of medical doctors expecting to be reimbursed for providing health promotion and wellness services (at rates exceeding $200/ hour), health coaches could easily provide this service at one-fifth the cost. They would also present a more friendly, accessible, peer-support approach to individuals. The specialized training of medical doctors is best directed to complex cases, whether acute or chronic.

The entire continuum of care needs to be re-examined and opened up to include reimbursement for health professionals that investigate the foundational causes of chronic illness, and who understand and have specialized skills in countering the ill effects of unhealthy lifestyles-professionals such as Nurse Practitioners, Naturopathic Doctors, and Traditional Chinese Medicine doctors, Homeopathic doctors, and Chiropractors.

For too long, there has been an active collusion barring the advancement of these professions by certain medical organizations with insurance companies, and the public has suffered as a result.

When these allied health professionals spoke up, demanding inclusion at the reimbursement table at the Summit on Integrative Medicine, a few medical doctors such as Dean Ornish, MD, championed this democratizing of the medical landscape, but others kept insisting that their own practices could accomplish wellness services, if only they were properly reimbursed.

However, reimbursement for lifestyle counseling should not have to include the major overhead encountered by medical doctors, including their clinical offices, costly tuition loans, high-tech equipment, numerous staff and billing clerks.

It’s been said that the US health care system is neither healthy nor much of a system. I believe it’s always darkest before the dawn of a new era, and these dark days of an ailing system must mean the light is about to break over the horizon.

Bringing health coaches into the US health care system can address the colossal “elephant in the middle of the room”-that the burden of disease and related health costs can be dramatically lowered through healthy behavioral change. Learning to move more, eat well and less, and de-stress often, is not only a prescription for a better life, it’s an Rx for US health care reform.